| NPI | 1053719773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARDAD FOROUZANPOUR Director 310-360-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 2oa7188) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2024-01-24 |